<s>
Emergency	B-Algorithm
ultrasound	I-Algorithm
employing	O
point-of-care	B-Algorithm
ultrasound	I-Algorithm
(	O
POCUS	B-Algorithm
)	O
is	O
the	O
application	O
of	O
ultrasound	B-Application
at	O
the	O
point	O
of	O
care	O
to	O
make	O
immediate	O
patient-care	O
decisions	O
.	O
</s>
<s>
This	O
point-of-care	O
use	O
of	O
ultrasound	B-Application
is	O
often	O
to	O
evaluate	O
an	O
emergency	O
medical	O
condition	O
,	O
in	O
settings	O
such	O
as	O
an	O
emergency	O
department	O
,	O
critical	O
care	O
unit	O
,	O
ambulance	O
,	O
or	O
combat	O
zone	O
.	O
</s>
<s>
Emergency	B-Algorithm
ultrasound	I-Algorithm
is	O
used	O
to	O
quickly	O
diagnose	O
a	O
limited	O
set	O
of	O
injuries	O
or	O
pathologic	O
conditions	O
,	O
specifically	O
those	O
where	O
conventional	O
diagnostic	O
methods	O
would	O
either	O
take	O
too	O
long	O
or	O
would	O
introduce	O
greater	O
risk	O
to	O
a	O
person	O
(	O
either	O
by	O
transporting	O
the	O
person	O
away	O
from	O
the	O
most	O
closely	O
monitored	O
setting	O
,	O
or	O
exposing	O
them	O
to	O
ionizing	O
radiation	O
and/or	O
intravenous	B-Application
contrast	I-Application
agents	I-Application
)	O
.	O
</s>
<s>
Point	B-Algorithm
of	I-Algorithm
care	I-Algorithm
ultrasound	I-Algorithm
has	O
been	O
used	O
in	O
a	O
wide	O
variety	O
of	O
specialties	O
and	O
has	O
increased	O
in	O
use	O
in	O
the	O
last	O
decade	O
as	O
ultrasound	B-Application
machines	I-Application
have	O
become	O
more	O
compact	O
and	O
portable	O
.	O
</s>
<s>
In	O
contrast	O
to	O
a	O
comprehensive	O
ultrasound	B-Application
examination	O
,	O
which	O
is	O
typically	O
performed	O
by	O
a	O
sonographer	O
and	O
interpreted	O
by	O
a	O
specialist	O
,	O
point-of-care	B-Algorithm
ultrasound	I-Algorithm
examinations	O
are	O
performed	O
and	O
interpreted	O
by	O
the	O
same	O
clinician	O
and	O
are	O
typically	O
narrower	O
in	O
scope	O
.	O
</s>
<s>
Point	B-Algorithm
of	I-Algorithm
care	I-Algorithm
ultrasound	I-Algorithm
is	O
sometimes	O
the	O
only	O
option	O
in	O
the	O
evaluation	O
of	O
injured	O
persons	O
who	O
are	O
too	O
ill	O
for	O
transport	O
to	O
other	O
imaging	O
modalities	O
(	O
i.e.	O
</s>
<s>
For	O
people	O
who	O
present	O
signs	O
of	O
traumatic	O
injury	O
,	O
the	O
focused	O
assessment	O
with	O
sonography	B-Application
for	O
trauma	O
or	O
FAST	O
exam	O
is	O
used	O
to	O
assess	O
hypotensive	O
persons	O
for	O
occult	O
bleeding	O
.	O
</s>
<s>
Similarly	O
,	O
emergency	B-Algorithm
ultrasound	I-Algorithm
can	O
also	O
evaluate	O
the	O
lungs	O
for	O
hemothorax	O
(	O
bleeding	O
in	O
the	O
chest	O
)	O
,	O
and	O
pneumothorax	O
(	O
a	O
puncture	O
resulting	O
in	O
air	O
trapped	O
in	O
the	O
chest	O
and	O
lung	O
collapse	O
)	O
.	O
</s>
<s>
People	O
presenting	O
with	O
hypotension	O
of	O
unknown	O
cause	O
,	O
ultrasound	B-Application
has	O
been	O
utilized	O
to	O
determine	O
the	O
cause	O
of	O
shock	O
.	O
</s>
<s>
A	O
person	O
who	O
has	O
hypotension	O
and	O
a	O
bedside	O
ultrasound	B-Application
showing	O
hyperdynamic	O
left	O
heart	O
with	O
a	O
flat	O
,	O
collapsible	O
IVC	O
indicates	O
low	O
blood	O
volume	O
.	O
</s>
<s>
For	O
those	O
presenting	O
with	O
acute	O
shortness	O
of	O
breath	O
,	O
ultrasound	B-Application
assessment	O
of	O
the	O
lung	O
,	O
heart	O
,	O
and	O
IVC	O
can	O
evaluate	O
for	O
potentially	O
life-threatening	O
diseases	O
,	O
including	O
pneumothorax	O
,	O
significant	O
pleural	O
effusions	O
,	O
congestive	O
heart	O
failure	O
,	O
pulmonary	O
edema	O
,	O
pericardial	O
effusion	O
,	O
and	O
some	O
large	O
pulmonary	O
emboli	O
.	O
</s>
<s>
With	O
its	O
increased	O
availability	O
,	O
ultrasound	B-Application
is	O
now	O
frequently	O
used	O
more	O
in	O
code	O
situations	O
,	O
in	O
which	O
a	O
person	O
have	O
lost	O
most	O
or	O
all	O
signs	O
of	O
life	O
.	O
</s>
<s>
Practitioners	O
may	O
use	O
the	O
ultrasound	B-Application
to	O
see	O
if	O
the	O
heart	O
is	O
moving	O
,	O
beating	O
in	O
organized	O
fashion	O
or	O
if	O
it	O
has	O
a	O
pericardial	O
effusion	O
or	O
fluid	O
around	O
it	O
.	O
</s>
<s>
Emergency	B-Algorithm
ultrasound	I-Algorithm
can	O
not	O
only	O
diagnose	O
,	O
but	O
also	O
monitor	O
a	O
person	O
's	O
response	O
to	O
therapeutic	O
interventions	O
.	O
</s>
<s>
Ultrasound	B-Application
can	O
be	O
utilized	O
to	O
assess	O
a	O
person	O
's	O
intravascular	O
volume	O
status	O
and	O
response	O
to	O
intravenous	O
fluid	O
therapy	O
by	O
measuring	O
the	O
size	O
and	O
respiratory	O
change	O
in	O
the	O
diameter	O
of	O
the	O
IVC	O
,	O
including	O
the	O
assessment	O
of	O
central	O
venous	O
collapsibility	O
as	O
a	O
more	O
standardized	O
measure	O
of	O
intravascular	O
volume	O
status	O
.	O
</s>
<s>
More	O
recent	O
evidence	O
suggests	O
that	O
ultrasound	B-Application
assessment	O
of	O
more	O
"	O
peripheral	O
"	O
veins	O
(	O
e.g.	O
,	O
subclavian	O
,	O
femoral	O
,	O
internal	O
jugular	O
)	O
may	O
also	O
be	O
helpful	O
in	O
estimating	O
intravascular	O
volume	O
status	O
in	O
the	O
absence	O
of	O
IVC	O
visualization	O
.	O
</s>
<s>
Ultrasound	B-Application
of	O
the	O
lungs	O
may	O
demonstrate	O
resolution	O
of	O
pulmonary	O
edema	O
from	O
congestive	O
heart	O
failure	O
.	O
</s>
<s>
Using	O
ultrasound	B-Application
to	O
guide	O
needles	O
during	O
procedures	O
may	O
improve	O
success	O
and	O
decrease	O
complications	O
in	O
procedures	O
performed	O
by	O
multiple	O
specialties	O
,	O
including	O
central	O
and	O
venous	O
access	O
,	O
arterial	O
cannulation	O
,	O
thoracentesis	O
,	O
paracentesis	O
,	O
pericardiocentesis	O
,	O
arthrocentesis	O
,	O
regional	O
anesthesia	O
,	O
incision	O
and	O
drainage	O
of	O
abscesses	O
,	O
localization	O
and	O
removal	O
of	O
foreign	O
bodies	O
,	O
lumbar	O
puncture	O
,	O
biopsies	O
,	O
and	O
other	O
procedures	O
.	O
</s>
<s>
Point-of-care	B-Algorithm
ultrasound	I-Algorithm
is	O
being	O
increasingly	O
used	O
to	O
speed	O
patient	O
care	O
and	O
to	O
avoid	O
ionizing	O
radiation	O
.	O
</s>
<s>
The	O
efficiency	O
of	O
obtaining	O
the	O
answer	O
to	O
a	O
focused	O
question	O
within	O
minutes	O
is	O
one	O
of	O
the	O
driving	O
forces	O
of	O
the	O
popularity	O
of	O
bedside	O
ultrasound	B-Application
.	O
</s>
<s>
Those	O
presenting	O
with	O
chest	O
pain	O
,	O
focused	O
cardiac	B-Application
ultrasound	I-Application
can	O
be	O
helpful	O
in	O
the	O
evaluation	O
of	O
persons	O
with	O
potentially	O
life-threatening	O
disease	O
such	O
as	O
a	O
pericardial	O
effusion	O
,	O
a	O
severe	O
pulmonary	O
embolus	O
(	O
or	O
blood	O
clot	O
in	O
the	O
lungs	O
)	O
,	O
or	O
in	O
screening	O
those	O
with	O
suspected	O
aortic	O
dissection	O
.	O
</s>
<s>
The	O
use	O
of	O
ultrasound	B-Application
is	O
also	O
helpful	O
in	O
persons	O
with	O
chest	O
pain	O
due	O
to	O
suspected	O
heart	O
ischemia	O
,	O
especially	O
when	O
the	O
baseline	O
electrocardiogram	B-Application
or	O
EKG	B-Application
,	O
is	O
non-diagnostic	O
.	O
</s>
<s>
The	O
more	O
technically	O
demanding	O
aspects	O
of	O
echocardiographic	B-Application
interpretation	O
,	O
and	O
should	O
be	O
reserved	O
for	O
more	O
formal	O
comprehensive	O
echocardiography	B-Application
.	O
</s>
<s>
Bedside	O
ultrasound	B-Application
assesses	O
the	O
gallbladder	O
for	O
presence	O
of	O
gallstones	O
that	O
cause	O
the	O
majority	O
of	O
gallbladder	O
illness	O
.	O
</s>
<s>
Emergency	B-Algorithm
ultrasound	I-Algorithm
of	O
the	O
gallbladder	O
can	O
help	O
speed	O
diagnosis	O
and	O
care	O
.	O
</s>
<s>
If	O
obstructing	O
kidney	O
stones	O
are	O
suspected	O
,	O
the	O
kidneys	O
can	O
be	O
evaluated	O
by	O
ultrasound	B-Application
for	O
signs	O
of	O
obstruction	O
,	O
called	O
hydronephrosis	O
.	O
</s>
<s>
A	O
common	O
use	O
of	O
ultrasound	B-Application
is	O
identifying	O
or	O
evaluating	O
the	O
fetus	O
in	O
a	O
person	O
who	O
is	O
pregnant	O
.	O
</s>
<s>
A	O
bedside	O
ultrasound	B-Application
can	O
determine	O
the	O
presence	O
or	O
absence	O
of	O
blood	O
clots	O
and	O
their	O
location	O
in	O
the	O
proximal	O
lower	O
extremity	O
to	O
behind	O
the	O
knee	O
.	O
</s>
<s>
Those	O
presenting	O
with	O
eye	O
pain	O
or	O
visual	O
loss	O
,	O
ultrasound	B-Application
of	O
the	O
eye	O
can	O
be	O
used	O
for	O
the	O
detection	O
of	O
orbital	O
pathology	O
.	O
</s>
<s>
Ultrasound	B-Application
has	O
been	O
described	O
to	O
detect	O
retinal	O
detachments	O
,	O
vitreous	O
hemorrhage	O
,	O
dislocation	O
of	O
the	O
lens	O
,	O
as	O
well	O
as	O
evaluating	O
optic	B-Application
nerve	I-Application
sheath	O
diameters	O
as	O
a	O
potential	O
indicator	O
of	O
other	O
diseases	O
in	O
the	O
central	O
nervous	O
system	O
.	O
</s>
<s>
Now	O
that	O
ultrasound	B-Application
is	O
available	O
in	O
portable	B-Algorithm
units	I-Algorithm
that	O
are	O
smaller	O
than	O
laptop	O
computers	O
and	O
handheld	O
models	O
,	O
it	O
is	O
being	O
used	O
more	O
and	O
more	O
in	O
many	O
clinical	O
settings	O
.	O
</s>
<s>
Many	O
practitioners	O
use	O
point-of-care	B-Algorithm
ultrasound	I-Algorithm
in	O
diagnosing	O
other	O
urgent	O
and	O
emergency	O
problems	O
,	O
including	O
appendicitis	O
,	O
testicular	O
torsion	O
,	O
and	O
abscesses	O
.	O
</s>
<s>
To	O
describe	O
each	O
of	O
these	O
fully	O
is	O
beyond	O
the	O
scope	O
of	O
this	O
entry	O
,	O
and	O
impossible	O
as	O
the	O
use	O
of	O
ultrasound	B-Application
is	O
expanding	O
rapidly	O
:	O
</s>
<s>
Emergency	O
and	O
point-of-care	B-Algorithm
ultrasound	I-Algorithm
is	O
taught	O
in	O
a	O
variety	O
of	O
settings	O
.	O
</s>
<s>
Many	O
physicians	O
are	O
currently	O
taught	O
bedside	O
ultrasound	B-Application
during	O
the	O
emergency	O
medicine	O
residency	O
or	O
critical	O
care	O
fellowship	O
training	O
programs	O
in	O
the	O
United	O
States	O
.	O
</s>
<s>
There	O
are	O
specialized	O
fellowship	O
training	O
programs	O
for	O
bedside	O
ultrasound	B-Application
in	O
emergency	O
medicine	O
,	O
but	O
these	O
are	O
not	O
required	O
nor	O
expected	O
for	O
the	O
use	O
of	O
this	O
tool	O
in	O
practice	O
.	O
</s>
